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CT findings in spastic cerebral palsy. Clinical, aetiological and prognostic aspects
Insights
Cranial CT scans reveal that 67% of children with cerebral palsy (CP) have abnormal findings. Pathological results correlate with motor handicap severity and epilepsy, with atrophy being the most common abnormality in CP patients.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Cranial computed tomography (CT) offers a non-invasive method to assess pathophysiological changes in children with cerebral palsy (CP).
- Understanding CT findings in CP is crucial for diagnosis and management.
Purpose of the Study:
- To describe cranial CT findings in children with CP.
- To correlate these findings with CP type, handicap severity, etiology, and associated neurological deficits.
Main Methods:
- CT examinations were performed on 83 children diagnosed with spastic CP.
- Data were analyzed to identify correlations between CT findings and clinical characteristics.
Main Results:
- 67% of children (57 out of 83) exhibited pathological CT findings.
- Pathological CT findings increased with the severity of motor handicap (p<0.05).
- Epilepsy was significantly associated with abnormal CT scans (p<0.05).
- Infarction and hemiatrophy were more prevalent in hemiplegic CP (p<0.001).
- Atrophy, particularly central atrophy with ventricular enlargement, was the most frequent abnormality (44 cases).
Conclusions:
- Cranial CT is valuable in evaluating children with CP, revealing abnormalities in a majority of cases.
- CT findings correlate with the severity of motor impairment and the presence of epilepsy.
- Specific findings like atrophy and infarction are linked to particular CP types, aiding in understanding the underlying pathophysiology.
Abstract:
After the introduction of cranial computed tomography (CT) it is now possible by an atraumatic procedure to evaluate the pathophysiological findings in children suffering from cerebral palsy (CP). The aim of this study is to describe the cranial CT findings in children with CP and relate these to CP-type, grade of handicap, aetiology, and presence of other functional cerebral defects. The CT-examination was performed in 83 children with spastic CP (44 boys and 39 girls). Fifty-seven children (67%) had pathological CT. There was no statistically significant difference between the frequencies of pathological CT findings in the groups with tetraplegia, diplegia, and paraplegia. The frequency of pathological CT findings was increasing with increasing severity of the motor handicap (p less than 0.05). There were significantly more children with pathological CT findings among CP children suffering from epilepsy, than among CP children without epilepsy (p less than 0.05). The CP children with the lowest IQ, had numerical more pathological CT findings but there was no significant difference among pathological CT findings in CP children with oligophrenia compared to the rest of the group. Infarction, its sequelae and hemiatrophy were much more frequent in patients with hemiplegia (p less than 0.001) compared to the other CP-types. The most frequent pathological CT finding was atrophy (44 cases among 56 pathological CT). Central atrophy with enlargement of the ventricular system or parts of this was found in 39 children.(ABSTRACT TRUNCATED AT 250 WORDS)